title: Structured outpatient peritoneal dialysis catheter insertion is safe and cost-saving.
abstract: BACKGROUND
  Data about outcomes and costs for peritoneal catheter insertion on an outpatient basis are scarce.
  
  
  METHODS
  Using patient files, all peritoneal dialysis (PD) catheter insertions performed between 2004 and 2009 in a single-center tertiary care institution for adult patients were located. Patient demographics, complications, hospitalizations, survival, and treatment modality changes were recorded. Procedure-related expenses were valued as actual production costs.
  
  
  RESULTS
  During the study period, 106 PD catheters were inserted. In 46 cases, the patients were admitted electively for catheter insertion; 19 catheters were placed during admission for other medical reasons; and 41 catheters were placed on an outpatient basis. Among the study patients (54.7 ± 16.0 years of age), 45% were diabetic. Early (<30 days) catheter-related complications occurred in 22% of patients. The incidences of technique failure and any complication within 90 days were 10% and 38% respectively. The occurrence of complications was not statistically significantly different for outpatients and electively admitted patients. Average costs for catheter insertion were higher in electively hospitalized patients than in outpatients (€2320 ± €960 vs €1346 ± €208, p < 0.000).
  
  
  CONCLUSIONS
  Compared with an inpatient procedure, outpatient insertion of a PD catheter results in similar outcomes at a lower cost.
authors.affiliation: Department of Medicine, Tampere University Hospital, and Medical School, University of Tampere, Tampere, Finland.
authors.forename: Tapani E
authors.initials: TE
authors.lastname: Salonen
authors.affiliation: Department of Medicine, Tampere University Hospital, and Medical School, University of Tampere, Tampere, Finland.
authors.forename: Heikki
authors.initials: H
authors.lastname: Saha
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D000556:Ambulatory Surgical Procedures / Q000191:economics / Q000379:methods*; D002408:Catheters, Indwelling / Q000191:economics*; D015331:Cohort Studies; D017046:Cost Savings; D005260:Female; D005387:Finland; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D061214:Patient Safety; D010530:Peritoneal Dialysis / Q000191:economics* / Q000295:instrumentation*; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D055815:Young Adult
keywords: Peritoneal dialysis catheter; costs; insertion; outpatients; peritonitis; technique failure